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The Journal of pediatrics, 2023-08, Vol.259, p.113443-113443, Article 113443
2023
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Autor(en) / Beteiligte
Titel
Early-Life Outcomes in Relation to Social Determinants of Health for Children Born Extremely Preterm
Ist Teil von
  • The Journal of pediatrics, 2023-08, Vol.259, p.113443-113443, Article 113443
Ort / Verlag
United States: Elsevier Inc
Erscheinungsjahr
2023
Quelle
MEDLINE
Beschreibungen/Notizen
  • To characterize the relationships between social determinants of health (SDOH) and outcomes for children born extremely preterm. This is a cohort study of infants born at 22-26 weeks of gestation in National Institute of Child Health and Human Development Neonatal Research Network centers (2006-2017) who survived to discharge. Infants were classified by 3 maternal SDOH: education, insurance, and race. Outcomes included postmenstrual age (PMA) at discharge, readmission, neurodevelopmental impairment (NDI), and death postdischarge. Regression analyses adjusted for center, perinatal characteristics, neonatal morbidity, ethnicity, and 2 SDOH (eg, group comparisons by education adjusted for insurance and race). Of 7438 children, 5442 (73%) had at least 1 risk-associated SDOH. PMA at discharge was older (adjusted mean difference 0.37 weeks, 95% CL 0.06, 0.68) and readmission more likely (aOR 1.27, 95% CL 1.12, 1.43) for infants whose mothers had public/no insurance vs private. Neither PMA at discharge nor readmission varied by education or race. NDI was twice as likely (aOR 2.36, 95% CL 1.86, 3.00) and death 5 times as likely (aOR 5.22, 95% CL 2.54, 10.73) for infants with 3 risk-associated SDOH compared with those with none. Children born to mothers with public/no insurance were older at discharge and more likely to be readmitted than those born to privately insured mothers. NDI and death postdischarge were more common among children exposed to multiple risk-associated SDOH at birth compared with those not exposed. Addressing disparities due to maternal education, insurance coverage, and systemic racism are potential intervention targets to improve outcomes for children born preterm.
Sprache
Englisch
Identifikatoren
ISSN: 0022-3476, 1097-6833
eISSN: 1097-6833
DOI: 10.1016/j.jpeds.2023.113443
Titel-ID: cdi_proquest_miscellaneous_2807919485

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